Provider Demographics
NPI:1063858090
Name:BOHNKER, SUZANNE ELAINE (ANP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ELAINE
Last Name:BOHNKER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 3RD AVE
Mailing Address - Street 2:SUITE 28A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-2803
Mailing Address - Country:US
Mailing Address - Phone:314-514-6000
Mailing Address - Fax:866-497-1239
Practice Address - Street 1:999 EXECUTIVE PARKWAY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6336
Practice Address - Country:US
Practice Address - Phone:314-514-6000
Practice Address - Fax:866-497-1239
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306-155-1363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine